Hazardous Materials

Information Review Act Appeal

Board Procedures Regulations	FORM 3

[Section 8]

APPEAL BOARD

HAZARDOUS MATERIALS INFORMATION REVIEW ACT

IN THE MATTER OF:	An appeal pursuant to section 20 of the Hazardous Materials Information Review Act by __________________________________________________ from the decision of the

(name person)

screening officer dated ____________________, 20___, in relation to a claim for exemption bearing Registry Number ______________.

OR

An application for an order pursuant to subsection 26(1) of the Hazardous Materials Information Review Act by __________________________________________________

(name person)

NOTICE OF APPEAL OR APPLICATION

APPEAL OR APPLICATION NUMBER: ______________

An appeal has been commenced by ________________________________________ from the decision or
(name person)

order of the Screening Officer dated ___________________, 20___, in relation to a claim for exemption made by

_________________________________________ bearing Registry Number ________. The decision or order

(name person)

appealed from provided that (include a brief summary of the decision or order):

The appellant states that (include a brief summary of the grounds of appeal):

AND

(Where the appeal includes an application)

The appellant has applied, pursuant to subsection 26(1) of the Hazardous Materials Information Review Act, for an order requiring the claimant to disclose, in confidence, confidential business information to affected parties. The appellant states that (include a brief statement of the reasons for the application):

OR

(Where there is no appeal)

An application has been made by ________________________________________ pursuant to

(name person)

subsection 26(1) of the Hazardous Materials Information Review Act for an order requiring _________________________________________ to disclose, in confidence, confidential business information

(name of claimant)

to affected parties. The application states that (include a brief statement of the reasons for the application):

The appeal or the application, or both, will be heard by an appeal board consisting of ____________________, Chairman, and _______________________ and ______________________, Members.

Any affected party or the claimant, where the claimant is not the appellant, who intents to participate in the appeal or application or in both shall advise the appeal board by filing an Appearance with the appeal board and serving a copy of the Appearance on the appellant or the applicant on or before __________________________.

(date)

The address for service on the appellant or applicant is:

ADDRESS:	_______________________________________________

_______________________________________________

TELEPHONE:	_______________________________________________

OTHER MEANS OF TELECOMMUNICATIONS

AND THEIR NUMBERS:	_______________________________________________

_______________________________________________

Copies of the form of Appearance as well as information as to appeal board procedures may be obtained from the Office of the Chief Appeals Officer at:

NAME OF CHIEF APPEALS OFFICER:	_______________________________________________

HAZARDOUS MATERIALS INFORMATION

REVIEW COMMISSION ADDRESS:	_______________________________________________

_______________________________________________

TELEPHONE:	_______________________________________________

OTHER MEANS OF TELECOMMUNICATIONS

AND THEIR NUMBERS:	_______________________________________________

_______________________________________________

Dated at Ottawa this _______ day of _________________, 20___.

_____________________________

Chief Appeals Officer